[Ankylosing spondylarthritis, HLA B27 and the theory of crossed tolerance].
The association between HLA-B27 and ankylosing spondylitis could be explained by a theory of crossed tolerance, which proposes that Gram negative bacteria have antigens similar to HLA-B27. Experimental studies with human sera with anti-HLA specificity and rabbit sera with anti-Klebsiella specificity demonstrate a partial crossed reactivity between HLA-B27 and Klebsiella. Clinical studies have shown that Klebsiella can be isolated from patients with ankylosing spondylitis during relapses or active phases of the disease. The theory of crossed tolerance proposes that ankylosing spondylitis is a reactive arthritis which develops after infection with Gram negative bacteria. The agent directly involved in causing the disease is an anti-bacterial antibody which binds to self antigens with partial crossed reactivity, such as HLA-B27, and the inflammation develops as a result of triggering of the complement cascade by the antigen-antibody complex.


Improvements in bones and stones consolidating processes by vacuum system method.
The degradation of materials commonly starts on the surface of the object and proceeds towards inside through pores, increasing fractures and lesions. To restore mechanical and aesthetic characteristics, it is necessary by the application of consolidants to fill these weak points so that they become inaccessible to corrosive agents. Greater is the amount of consolidant that penetrates, greater the efficiency of the restoration. This is the limiting factor of many approaches which due to very tight pores result not fully successful. The consolidation under vacuum can help to pass these difficulties. So we have adopted it to restore Macco samples and tested to consolidate archaeological bones. The samples were consolidated by complete immersion under vacuum (-700 mm Hg), in a consolidant solution containing 8% w/V of diammonium phosphate. The success of the application to both the kind of samples is shown by microscope images, SEM-EDAX analysis, and weight variation.


[Mitral valve prolapse and mitral annulus disjunction: be aware of a potential arrhythmogenic substrate].
Mitral valve prolapse is a relatively common disease with a good overall prognosis. However, in specific clinical and instrumental contexts, patients at high risk of ventricular arrhythmias and sudden cardiac death can be identified. Female sex, history of palpitations or syncope, bi-leaflet myxomatous valve, ECG repolarization abnormalities in the inferior leads, complex ventricular arrhythmias, left ventricular fibrosis detected by cardiac magnetic resonance correlate with a higher risk clinical profile. Additionally, morpho-functional abnormalities of the mitral valve annulus, particularly mitral annulus disjunction, may cause a mechanical stretch at the inferior basal ventricular wall and posterior papillary muscles, predisposing to myocardial fibrosis and arrhythmias. A risk stratification strategy is needed to identify patients with mitral valve prolapse and/or mitral annulus disjunction at high risk of arrhythmias; however, few data are available. Further prospective multicenter studies are warranted, focusing on medical therapy, the role of implantable cardioverter-defibrillators for primary prevention, efficacy of targeted catheter ablation or mitral valve surgery.


Expression of epithelial-cell adhesion molecule (Ep-CAM) in small cell lung cancer as defined by monoclonal antibodies 17-1A and BerEP4.
Small cell lung cancer (SCLC) comprises 15-20% of all lung cancer. Despite high initial response to chemotherapy chemoresistance at relapse leads to a less than 5% five-year survival rate. Adjuvant treatment with monoclonal antibodies (Mabs) against SCLC antigens may offer a therapeutic option. Mab 17-1A directed against the epithelial-cell adhesion molecule (Ep-CAM) has been extensively tested for therapy in patients with colorectal carcinoma. Expression of Ep-CAM in SCLC has been earlier described. However, reactivity of Mab 17-1A and another Ep-CAM-binding Mab BerEP4 has not yet been described for SCLC. Using immunohistology first with BerEP4 and confirmatory with 17-1A a homogenous and strong expression of Ep-CAM was seen in all SCLC specimens tested (n = 10). For comparison, heterogenous expression was seen in the non-SCLC tumors tested (n = 15). These findings strongly suggest that Mab 17-1A can be useful for adjuvant immunotherapy in patients with SCLC. For detection of Ep-CAM in tumor tissue in patients that might be considered for immunotherapy with Mab 17-1A, Mab BerEP4 appears to be preferred.


A MEMS Resonant Sensor to Measure Fluid Density and Viscosity under Flexural and Torsional Vibrating Modes.
Methods to calculate fluid density and viscosity using a micro-cantilever and based on the resonance principle were put forward. Their measuring mechanisms were analyzed and the theoretical equations to calculate the density and viscosity were deduced. The fluid-solid coupling simulations were completed for the micro-cantilevers with different shapes. The sensing chips with micro-cantilevers were designed based on the simulation results and fabricated using the micro electromechanical systems (MEMS) technology. Finally, the MEMS resonant sensor was packaged with the sensing chip to measure the densities and viscosities of eight different fluids under the flexural and torsional vibrating modes separately. The relative errors of the measured densities from 600 kg/m³ to 900 kg/m³ and viscosities from 200 μPa·s to 1000 μPa·s were calculated and analyzed with different microcantilevers under various vibrating modes. The experimental results showed that the effects of the shape and vibrating mode of micro-cantilever on the measurement accuracies of fluid density and viscosity were analyzed in detail.


Age ≥ 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors in patients with type 2 diabetes mellitus.
Providing effective medical care for older patients with type 2 diabetes mellitus (T2D) that may contribute to their active aging has always been challenging. We examined the independent effect of age ≥ 60 years on disease control and its relationship with diabetes-related complications in patients with T2D in Malaysia. This was a cross-sectional study using secondary data from the electronic diabetes registry database Adult Diabetes Control and Management (ADCM). A total of 303 centers participated and contributed a total of 70,889 patients from May 2008 to the end of 2009. Demographic data, details on diabetes, hypertension, dyslipidemia and their treatment modalities, various risk factors and complications were updated annually. Independent associated risk factors were identified using multivariate regression analyses. Fifty-nine percent were female. Malay comprised 61.9%, Chinese 19% and Indian 18%. There were more Chinese, men, longer duration of diabetes and subjects that were leaner or had lower BMI in the older age group. Patients aged ≥ 60 years achieved glycemic and lipid targets but not the desired blood pressure. After adjusting for duration of diabetes, gender, ethnicity, body mass index, disease control and treatment, a significantly higher proportion of patients ≥ 60 years suffered from reported diabetes-related complications. Age ≥ 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors. Our findings caution against the currently recommended control of targets in older T2D patients with more longstanding diseases and complications.


Maxi-anion channels play a key role in glutamate-induced ATP release from mouse astrocytes in primary culture.
Astrocytes are an abundant source of ATP, which might be released from the cytosol into extracellular spaces under various conditions and even affect cell fate under some circumstances. In the present study, we aimed to evaluate the pathway(s) contributing toward glutamate-induced ATP release from mouse astrocytes. Firstly, our study of cultured astrocytes showed marked ATP release in response to stimuli of glutamate at different concentrations (0.1-1 mM), with an interesting bimodal distribution in time course. Inhibitors or blockers of potential pathways for ATP release such as exocytotic vesicular release, gap junction hemichannels, P2X7 receptors, and volume-sensitive outwardly rectifying chloride channels had no significant effects on the observed ATP release. In contrast, glutamate-induced ATP release from astrocytes was significantly inhibited by gadolinium (50 µM), an inhibitor of a maxi-anion channel; meanwhile, the application of gadolinium can allay glutamate-induced cell injury significantly. Thus, we propose that the maxi-anion channel might play an important role in glutamate-induced ATP release from mouse astrocytes and inhibition of maxi-anion channel activities to reduce ATP release can produce protective effects in the case of glutamate stimuli.


Effect of different high pressure treatments on shucking, biochemical, physical and sensory characteristics of oysters to elaborate a traditional Taiwanese oyster omelette.
Whole oysters (Crassostrea gigas) were processed using high-pressure (HP) treatment (150-300 MPa) to determine their shucking and biochemical properties. Subsequently, HP-treated oysters were cooked at 160 degrees C for 90 s, as when preparing the oyster omelette dish, to evaluate their physical and sensory characteristics as compared to raw oysters. The treatments of 250 and 300 MPa for 2 min and 0 min, respectively, resulted in 100% release. The pH of HP-treated oysters increased slightly from 6.50 to 6.82, and the moisture contents of the HP-treated oysters with or without further cooking were all higher than those of the control. The brightness, yellowness and cutting strength of HP-treated oysters with further cooking changed insignificantly, while the redness decreased compared to the control. Sensory evaluation showed that oysters treated at 250 and 300 MPa oysters after cooking received higher quality scores than the control. HP processing at 250 and 300 MPa proved to be a good method for oyster shucking. The HP-treated oysters cooked in the oyster omelette are acceptable to consumers. Overall, the application of HP as a processing method to improve the quality and acceptability of oysters and their related products would be possible.


Effect of information and communication technology on nursing performance.
The aim of this study was to investigate the influence of information and communication technology use and skills on nursing performance. Questionnaires were prepared relating to using the technology, practical skills in utilizing information, the Six-Dimension Scale of Nursing Performance, and demographics. In all, 556 nurses took part (response rate, 72.6%). A two-way analysis of variance was used to determine the influence of years of nursing experience on the relationship between nursing performance and information and communication technology use. The results showed that the group possessing high technological skills had greater nursing ability than the group with low skills; the level of nursing performance improved with years of experience in the former group, but not in the latter group. Regarding information and communication technology use, the results showed that nursing performance improved among participants who used computers for sending and receiving e-mails, but it decreased for those who used cell phones for e-mail. The results suggest that nursing performance may be negatively affected if information and communication technology are inappropriately used. Informatics education should therefore be provided for all nurses, and it should include information use relating to cell phones and computers.


Feasibility of An Entirely Extracardiac, Minimally Invasive,Temporary Pacing System.
A completely extracardiac pacing system provides the potential for clinical advantages over existing device alternatives that require intravascular, endocardial, or epicardial contact. Preliminary studies evaluating the feasibility of cardiac pacing with a lead in the anterior mediastinum, outside the pericardium and circulatory system have been completed. These studies examined (1) the anatomic access route, (2) the usability of a delivery tool to facilitate lead placement, and (3) the pacing performance of the extracardiac lead. Feasibility evaluations included (1) a retrospective computed tomography analysis to characterize anatomic variations related to lead access, (2) accessing the anterior mediastinum in cadavers and human subjects using a custom delivery tool, and (3) acute clinical pacing performance. Major findings: (1) A total of 166 (95%) out of 174 patients had a viable lead access path through the fourth, fifth, or sixth intercostal space. (2) Access to the targeted implant location using a delivery tool was successful in all 5 cadavers and 3 humans without use of fluoroscopy and with an average lead delivery time of 121±52 s. No damage to the lung, pericardium, heart, or internal thoracic vessels occurred. (3) Pacing performance was tested in 6 human subjects showing a threshold voltage of 4.7 V (2.7-6.7), threshold pulse width of 1.8 ms (1.0-2.5), and an impedance of 1205 Ω (894-1786). R-wave amplitudes measured 9.6 mV (5.6-12.0). Results support the feasibility for this completely extracardiac pacing method in a heterogeneous patient population, using a minimally invasive, parasternal, delivery approach and with adequate sensing and thresholds suited for temporary pacing.


Screening for alcoholism in a psychiatric hospital.
The prevalence of alcoholism is generally underestimated in patients in private practices, general hospitals and psychiatric institutions. Even though the World Health Organization has advocated the concurrent use of laboratory test results and questionnaires for screening, these methods are seldom used together. In this study, patients admitted consecutively to the North Bay Psychiatric Hospital were screened for alcoholism using the Michigan Alcoholism Screening Test (MAST) and gamma-glutamyl-transferase plasma level. Unexpectedly, 56.7% of the entire sample were identified as possible alcoholics; of these, 73.5% were men and 26.5% were women. When rates for men and women were looked at separately, it was found that 66.2% of the men and 40.6% of the women were alcoholic. Participants who tested positive on one or both of the screening tests were offered a more complete evaluation of their drinking behaviour. A diagnosis of alcoholism was confirmed in 88.2% of the patients who agreed to participate further. The question remains whether the high prevalence rates found are a function of the particular sample studied (i.e., patients in a hospital which typically serves a socially disadvantaged sector of the population) or reflects a feature of the general population in this catchment area. A study is currently underway in general hospitals of North Eastern Ontario in an attempt to answer this question.


Short segment transpedicular Cotrel-Dubousset instrumentation: a porcine corpectomy model.
This study examines changes in stiffness in a three-level spinal construct utilizing transpedicular Cotrel-Dubousset instrumentation. In addition, we evaluated the effect of adding offset laminar hooks at the same level as the superior transpedicular fixation. Porcine lumbar spines (L-1 to L-5) were tested as: (a) intact spine, (b) intact spine with instrumentation, and (c) instrumented spine after L-3 corpectomy. Instrumented constructs were tested with and without laminar hooks placed at the level of superior transpedicular fixation. Constructs were tested in modes of axial compression and torsion in a MTS materials testing machine. The fully instrumented intact spines demonstrated a 28.0% stiffness increase over the intact spines in torsion (p < 0.005) and a 23.1% increase in the mode of axial compression (p < 0.0002). There was no statistically significant difference in axial or torsional stiffness in the instrumented intact spine constructs when hooks were added. In the corpectomy model, addition of the laminar hooks increased stiffness in axial compression an average of 26.9% (p < 0.002) and in torsion an average of 28.1% (p < 0.0005). This increase in stiffness may aid in preventing the postoperative progression of kyphosis noted in studies utilizing similar constructs in clinical application for the treatment of lumbar burst fractures.


[Pharmacokinetic study on oxalate in rats].
The pharmacokinetics of oxalate were studied in normal and nephrectomized rats, using radioisotope-labelled oxalate to resolve the mechanism of calcium oxalate stone formation. Plasma disappearance of 14C-oxalate was analyzed with a 2-compartment open model, and each compartment volume, the first-order rate constant for elimination, and the first-order rate constant for transfer between the central compartment and peripheral compartment were obtained. These values were compared with those for inulin. In normal rats, the total distribution volume was 57% of body weight for oxalate and 34% for inulin. The elimination rate constant from the central compartment for oxalate was lower than that for inulin, but oxalate had a much larger central compartment volume than inulin. Thus, the total clearance of oxalate was greater than that of inulin. In nephrectomized rats, total clearance of oxalate decreased to 1/6 of that in normal rats, while total clearance of inulin decreased to 1/27 of that in normal rats. These results suggest that oxalate is more diffusible than inulin, and that oxalate is excreted mainly from the kidney.


Simplification of superovulation induction by using polyvinylpyrrolidone as a solvent for FSH in rabbits.
With a view to simplify the method of inducing superovulation in rabbits, polyvinylpyrrolidone (PVP) was used as a solvent for follicle-stimulating hormone (FSH). As a result, it became clear that more than the equivalent number of ovulation points and fertilized ova that are obtainable by the conventional six injections of FSH were able to be obtained by only a single injection of FSH-PVP preparation. Inflammation or swelling of the tissue was not observed in the injection site or its vicinity. The results seem to enable simplification of superovulation induction by using PVP as a vehicle for FSH in rabbits. This finding could reduce injection distress to the animals and labor of the operator.


A Populus TIR1 gene family survey reveals differential expression patterns and responses to 1-naphthaleneacetic acid and stress treatments.
The plant hormone auxin is a central regulator of plant growth. TRANSPORT INHIBITOR RESPONSE 1/AUXIN SIGNALING F-BOX (TIR1/AFB) is a component of the E3 ubiquitin ligase complex SCF(TIR1/AFB) and acts as an auxin co-receptor for nuclear auxin signaling. The SCF(TIR1/AFB)-proteasome machinery plays a central regulatory role in development-related gene transcription. Populus trichocarpa, as a model tree, has a unique fast-growth trait to which auxin signaling may contribute. However, no systematic analyses of the genome organization, gene structure, and expression of TIR1-like genes have been undertaken in this woody model plant. In this study, we identified a total of eight TIR1 genes in the Populus genome that are phylogenetically clustered into four subgroups, PtrFBL1/PtrFBL2, PtrFBL3/PtrFBL4, PtrFBL5/PtrFBL6, and PtrFBL7/PtrFBL8, representing four paralogous pairs. In addition, the gene structure and motif composition were relatively conserved in each paralogous pair and all of the PtrFBL members were localized in the nucleus. Different sets of PtrFBLs were strongly expressed in the leaves, stems, roots, cambial zones, and immature xylem of Populus. Interestingly, PtrFBL1 and 7 were expressed mainly in vascular and cambial tissues, respectively, indicating their potential but different roles in wood formation. Furthermore, Populus FBLs responded differentially upon exposure to various stresses. Finally, over-expression studies indicated a role of FBL1 in poplar stem growth and response to drought stress. Collectively, these observations lay the foundation for further investigations into the potential roles of PtrFBL genes in tree growth and development.


Protective effect of pifithrin-alpha on brain ischemic reperfusion injury induced by bilateral common carotid arteries occlusion in gerbils.
Involvement of p53 has been implicated in apoptosis induced cell death in ischemic reperfusion injury. In the present study, we have investigated neuroprotective potential of pifithrin-alpha, a p53 inhibitor in bilateral common carotid arteries occlusion (5 min) model of global cerebral ischemia in Mongolian gerbils. Gerbils were treated with pifithrin-alpha 3 mg/kg, ip. 30 min prior to occlusion. There was a significant increase in neurological symptoms and locomotor activity in ischemic animals as compared with the sham-operated animals. Increase in neurological symptoms and locomotor activity was attenuated by pifithrin-alpha 3 mg/ kg, ip. Significant increase in the number of the surviving neurons in the hippocampal CA1 pyramidal region was observed in ischemic animals treated with pifithrin-alpha 3 mg/kg, ip. This study demonstrates the neuroprotective effect of pifithrin-alpha in global cerebral ischemia in gerbils.


Vanadate-dependent bromoperoxidases from Ascophyllum nodosum in the synthesis of brominated phenols and pyrroles.
Bromoperoxidases from the brown alga Ascophyllum nodosum, abbreviated as V(Br)PO(AnI) and V(Br)PO(AnII), show 41% sequence homology and differ by a factor of two in the percentage of α-helical secondary structures. Protein monomers organize into homodimers for V(Br)PO(AnI) and hexamers for V(Br)PO(AnII). Bromoperoxidase II binds hydrogen peroxide and bromide by approximately one order of magnitude stronger than V(Br)PO(AnI). In oxidation catalysis, bromoperoxidases I and II turn over hydrogen peroxide and bromide similarly fast, yielding in morpholine-4-ethanesulfonic acid (MES)-buffered aqueous tert-butanol (pH 6.2) molecular bromine as reagent for electrophilic hydrocarbon bromination. Alternative compounds, such as tribromide and hypobromous acid are not sufficiently electrophilic for being directly involved in carbon-bromine bond formation. A decrease in electrophilicity from bromine via hypobromous acid to tribromide correlates in a frontier molecular orbital (FMO) analysis with larger energy gaps between the π-type HOMO of, for example, an alkene and the σ*(Br,X)-type LUMO of the bromination reagent. By using this approach, the reactivity of substrates and selectivity for carbon-bromine bond formation in reactions mediated by vanadate-dependent bromoperoxidases become predictable, as exemplified by the synthesis of bromopyrroles occurring naturally in marine sponges of the genera Agelas, Acanthella, and Axinella.


An RT-PCR assay using oral fluid samples to detect rubella virus genome for epidemiological surveillance.
A reverse transcription nested polymerase chain reaction (RT-PCR) method was developed for detecting rubella virus (RV) RNA using primer pairs which targeted a variable region of the E1 gene. RV genome was detected in oral fluid, throat swabs, serum and tissue samples. This is the first report to show that RV genome can be detected in oral fluid samples, including acute cases < or = 2 days after onset of symptoms, which have previously only been used for antibody testing. This suggests that PCR is useful for assisting with early diagnosis when a sufficient IgM response may not have been mounted. The PCR amplicon of 553 nucleotides was also useful for molecular genotyping, which contributes to RV epidemiological surveillance.


Compulsive Thrombus Management in STEMI Interventions.
Thrombus is a fundamental concept in the pathophysiology of ST-elevated myocardial infarction (STEMI). Distal embolization and no reflow are associated with less angiographic success, reduced myocardial blush, less ST resolution after primary percutaneous coronary intervention, larger enzymatic infarct size, lower left ventricular ejection fraction at discharge, and higher long-term mortality. We believe that with the use of thrombectomy devices, these shortcomings can be minimized. Based on our experience from the Single Individual Community Experience Registry (SINCERE) database, we formulated a selective thrombus burden management strategy (the Mehta classification) for thrombus management.


The IL-33/ST2 axis is crucial in type 2 airway responses induced by Staphylococcus aureus-derived serine protease-like protein D.
Chronic airway inflammatory diseases, such as chronic rhinosinusitis with nasal polyps and asthma, show increased nasal Staphylococcus aureus colonization. Staphylococcus aureus-derived serine protease-like protein (Spl) D and other closely related proteases secreted by S aureus have recently been identified as inducers of allergic asthma in human subjects and mice, but their mechanism of action is largely unknown. We investigated the role of recombinant SplD in driving TH2-biased responses and IgE formation in a murine model of allergic asthma. Allergic asthma was induced in C57BL/6 J wild-type mice, Toll-like receptor (TLR) 4 knockout (Tlr4-/-) mice, and recombination-activating gene (Rag2) knockout (Rag2-/-) mice by means of repeated intratracheal applications of SplD. Inflammatory parameters in the airways were assessed by means of flow cytometry, ELISA, Luminex, and immunohistochemistry. Serum SplD-specific IgE levels were analyzed by using ELISA. We observed that repeated intratracheal exposure to SplD led to IL-33 and eotaxin production, eosinophilia, bronchial hyperreactivity, and goblet cell hyperplasia in the airways. Blocking IL-33 activity with a soluble ST2 receptor significantly decreased the numbers of eosinophils, IL-13+ type 2 innate lymphoid cells and IL-13+CD4+ T cells and IL-5 and IL-13 production by lymph node cells but had no effect on IgE production. SplD-induced airway inflammation and IgE production were largely dependent on the presence of the functional adaptive immune system and independent of TLR4 signaling. The S aureus-derived protein SplD is a potent allergen of S aureus and induces a TH2-biased inflammatory response in the airways in an IL-33-dependent but TRL4-independent manner. The soluble ST2 receptor could be an efficient strategy to interfere with SplD-induced TH2 inflammation but does not prevent the allergic sensitization.


Considerations for design and data analysis of noninferiority/superiority cardiovascular trials.
The Food and Drug Administration (FDA) guidance for evaluating cardiovascular (CV) risk in new antidiabetic therapies to treat type 2 diabetes released in December 2008 recommends that sponsors conduct appropriate data analysis to rule out CV safety concerns for drugs treating type 2 diabetes. CV trials of antidiabetic drugs and drugs of other indications for chronic conditions are usually large-scale/long-term trials and can be designed as adaptive noninferiority/superiority trials. In these trials, treatment effect may not manifest immediately after patients take study medication and there will be a dilution in treatment effect after treatment discontinuation. These factors should be taken into account for more precise planning of study sample size and timeline. In this paper, we first derive closed-form formulas for the number of events and total exposure as functions of many other trial parameters. We then outline some considerations for the design of an adaptive noninferiority/superiority CV trial based on ideas of other authors. We also use an example to illustrate the application of the methods.


γδ T cell-mediated individualized immunotherapy for hepatocellular carcinoma considering clinicopathological characteristics and immunosuppressive factors.
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. γδ T cells have been revealed to be promising candidates for immunotherapy in patients with HCC. However, the use of these cells in clinical practice has been demonstrated to be challenging. In the present study, γδ T cells isolated from the peripheral blood of patients with HCC (n=83) and healthy donors (n=15) were characterized. Flow cytometry was used to analyze the proportion, phenotype, tumor-killing capacity and cytokine secretion of regulatory T cells (Tregs) and γδ T17 cells in peripheral blood samples prior to and following amplification. Interleukin (IL)-17A levels in the supernatant was analyzed using an ELISA on days 3, 7, 10 and 14. The in vitro cytotoxicity of γδ T cells was measured using an MTT assay. It was revealed that zoledronate with IL-2 may efficiently expand γδ T cells sourced from the peripheral blood of patients with HCC. The amplification capacity of γδ T cells was associated with the clinicopathological characteristics of patients (clinical stage, levels of AFP and albumin, duration of disease, size and number of tumors, numbers of Tregs and γδ T17 cells, and levels of IL-17A). The proportion of γδ T cells positive for interferon-γ, tumor necrosis factor-α, granzyme B, perforin, and lysosome-associated membrane protein 1 was almost unchanged prior to and following amplification. Following amplification, the in vitro cytotoxicity of γδ T cells also remained unchanged. γδ T17 cells, Tregs and IL-17A levels were not altered during amplification. In summary, following in vitro amplification, circulating γδ T cells were revealed to possess features that may make them suitable for immunotherapy for HCC without increasing immunosuppressive factors. However, immunotherapy should be individualized according to the clinicopathological features of patients.


Differential susceptibility of Escherichia coli cells toward transition metal-doped and matrix-embedded ZnO nanoparticles.
Dependence of the antibacterial behavior on ZnO (TM-doped and surface-modified) nanoparticles on Escherichia coli cells has been investigated. ZnO nanoparticles that differ in size, activator ion and in the microenvironment in which these nanoparticles are embedded were used. Comprehensive antibacterial studies of these ZnO nanoparticles owing to their size and surface defects are carried out against E. coli cells. These studies have been carried out both in Luria-Bertani medium and on solid agar medium in the presence and absence of light. The differences in antibacterial effect have been quantified in terms of minimum inhibitory concentration, minimum bactericidal concentration, colony forming unit counts, and qualitatively evaluated by growth curves and disk diffusion tests. The difference in antibacterial activities of the ZnO nanoparticles may be attributed to the enhanced or reduced oxygen vacancies and defect states and could be attributed to the increased or decreased surface defects.


[Herbivore or carnivore? History of prions].
Transmissible subacute spongiform encephalopathies have been known for some times in man and in animals, but were considered of minor importance up to the development of the mad cow crisis. Bovine spongiform encephalopathy raises questions about nowadays farming and brings up the issue of cannibalism as a whole and imposed upon an herbivore. Even if the word cannibalism may seem excessive in the case of cattle, it is however true that BSE spreads from cow to cow through their feeding with meat and bone meal contaminated with infected bovine material. More generally this points out the problem of cannibalism among animal species.


Parasitoid Diaeretiella rapae (Hymenoptera: Braconidae) Adjusts Reproductive Strategy When Competing for Hosts.
Parasitoid fitness depends on its ability to manipulate reproductive strategies when in competition. This study investigated the parasitism and sex allocation strategies of the parasitic wasp Diaeretiella rapae McIntosh at a range of host (Brevicoryne brassicae L.) and conspecific densities. The results suggest that D. rapae females adjust their progeny production and progeny sex ratio with changing competition. When foraging alone, female D. rapae parasitize larger number of B. brassicae nymphs when the number of available hosts is increased, but the overall proportion of parasitized hosts decreases with increase in host density. The proportion of female offspring also decreases with elevated host density. Increase in the number of female D. rapae foraging together increased total parasitism, but reduced relative contribution of each individual female. The number of female progeny decreased when multiple females competed for the same host. However, foraging experience in the presence of one or more conspecifics increased the parasitism rate and proportion of female progeny. Competing females were more active during oviposition and had shorter lives. The study suggests that both host and foundress (female parasitoid) densities have significant effect on progeny production, sex allocation, and longevity of foraging females.


Oxytocin secretion is stimulated by changes in glucose metabolism.
Previous studies have shown that infusion of oxytocin into normal dogs increased plasma levels of insulin and glucagon. These responses were accompanied by increased rates of glucose production and overall glucose uptake. The purpose of the present study was to determine whether, conversely, changes in glucose metabolism would result in changes in oxytocin secretion. In normal dogs, injection of insulin (0.1 U/kg/iv) resulted in increased secretion of oxytocin which coincided with the hypoglycemic nadir, and the oxytocin levels remained elevated for the remaining 60 min, during which time plasma glucose levels were returning to normal. In dogs made diabetic with streptozocin, injection of insulin (1 U/kg/iv) evoked increased oxytocin secretion which began as the plasma glucose levels were falling from the control value of 400 mg/dl to about 170 mg/dl; the oxytocin levels remained above initial values for at least 90 min, during which period plasma glucose returned to normal glycemic values. In normal dogs, infusion of 2-deoxyglucose, which causes intracellular glucopenia, caused a prompt and sustained increase in plasma oxytocin levels. The data suggest that abrupt decreases in availability of glucose in the central nervous system, as induced experimentally by administration of 2-deoxyglucose or by a rapid fall in peripheral glucose levels, evokes secretion of oxytocin.


Sorbitol-fermenting Bifidobacteria are indicators of very recent human faecal pollution in streams and groundwater habitats in urban tropical lowlands.
Sorbitol-fermenting Bifidobacteria (SFB) proved to be an excellent indicator of very recent human faecal pollution (hours to days) in the investigated tropical stream and groundwater habitats. SFB were recovered from human faeces and sources potentially contaminated with human excreta. SFB were undetectable in animal faeces and environmental samples not contaminated with human faeces. Microcosm studies demonstrated a rapid die-off rate in groundwater (T90 value 0.6 days) and stream water (T90 value 0.9-1.7 days). Discrimination sensitivity analysis, including E. coli, faecal coliforms, total coliforms and Clostridium perfringens spores, revealed high ability of SFB to distinguish differing levels of faecal pollution especially for streams although high background levels of interfering bacteria can complicate its recovery on the used medium. Due to its faster die-off, as compared to many waterborne pathogens, SFB cannot replace microbiological standard parameters for routine water quality monitoring but it is highly recommendable as a specific and complementary tool when human faecal pollution has to be localized or verified. Because of its exclusive faecal origin and human specificity it seems also worthwhile to include SFB in future risk evaluation studies at tropical water resources in order to evaluate under which situations risks of infection may be indicated.


Cellular Senescence Is Induced by the Environmental Neurotoxin Paraquat and Contributes to Neuropathology Linked to Parkinson's Disease.
Exposure to the herbicide paraquat (PQ) is associated with an increased risk of idiopathic Parkinson's disease (PD). Therapies based on PQ's presumed mechanisms of action have not, however, yielded effective disease therapies. Cellular senescence is an anticancer mechanism that arrests proliferation of replication-competent cells and results in a pro-inflammatory senescence-associated secretory phenotype (SASP) capable of damaging neighboring tissues. Here, we demonstrate that senescent cell markers are preferentially present within astrocytes in PD brain tissues. Additionally, PQ was found to induce astrocytic senescence and an SASP in vitro and in vivo, and senescent cell depletion in the latter protects against PQ-induced neuropathology. Our data suggest that exposure to certain environmental toxins promotes accumulation of senescent cells in the aging brain, which can contribute to dopaminergic neurodegeneration. Therapies that target senescent cells may constitute a strategy for treatment of sporadic PD, for which environmental exposure is a major risk factor.


TIBIOFEMORAL JOINT MOBILIZATION IN THE SUCCESSFUL MANAGEMENT OF PATELLOFEMORAL PAIN SYNDROME: A CASE REPORT.
Patellofemoral pain syndrome (PFPS) is a common source of anterior knee pain. Controversy exists over the exact clinical findings which define PFPS, thus, diagnosis and management can be challenging for clinicians. There is paucity in the literature concerning joint mobilization as treatment for PFPS, particularly at the tibiofemoral joint, as standard management is currently focused on therapeutic exercise, orthotics, bracing and taping. Therefore, the purpose of this case report is to describe the effects of tibiofemoral joint mobilization in the successful treatment of an individual with chronic PFPS as it relates to pain, function and central processing of pain. Case Report. The subject was a 28-year-old female with a two year history of left anterior, inferior patellar knee pain consistent with chronic PFPS. She demonstrated diminished pressure pain threshold (PPT) and allodynia at the anterior knee, suggesting a component of central sensitization to her pain. She met several common diagnostic criteria for PFPS, however, only tibiofemoral anterior-posterior joint mobilization increased her pain. Subsequent treatment sessions (Visits 1-6) consisted of solely joint mobilization supplemented by instruction in a home exercise program (therapeutic exercise and balance training). As outcomes improved, treatment sessions (Visits 7-8) consisted of solely therapeutic exercise and balance training with focus on return to independent pain free functional activity. Improvements consistent with the minimally clinically important difference were noted on the Kujala Anterior Knee Pain Scale, Numeric Pain Rating Scale, Global Rating of Change (GROC). Scores on the Fear Avoidance-Belief Questionnaire (6/24 to 2/24 PA, 31/42 to 5/42 W), PPT (119 to 386 kPa) and Step Down Test (11 to 40 steps) also demonstrated improvement. At a two month follow up, the subject reported continued improvement in functional activity, 0/10 pain and GROC = +5. This case describes the successful use of tibiofemoral joint mobilization in a subject with chronic PFPS and supports the use of joint mobilization as management in PFPS, particularly in cases where a centrally mediated component of pain may be present. Therapy, Level 5.


Physiological activity of E. coli engineered to produce butyric acid.
Faecalibacterium prausnitzii (F. prausnitzii) is one of the most abundant bacteria in the human intestine, with its anti-inflammatory effects establishing it as a major effector in human intestinal health. However, its extreme sensitivity to oxygen makes its cultivation and physiological study difficult. F. prausnitzii produces butyric acid, which is beneficial to human gut health. Butyric acid is a short-chain fatty acid (SCFA) produced by the fermentation of carbohydrates, such as dietary fibre in the large bowel. The genes encoding butyryl-CoA dehydrogenase (BCD) and butyryl-CoA:acetate CoA transferase (BUT) in F. prausnitzii were cloned and expressed in E. coli to determine the effect of butyric acid production on intestinal health using DSS-induced colitis model mice. The results from the E. coli Nissle 1917 strain, expressing BCD, BUT, or both, showed that BCD was essential, while BUT was dispensable for producing butyric acid. The effects of different carbon sources, such as glucose, N-acetylglucosamine (NAG), N-acetylgalactosamine (NAGA), and inulin, were compared with results showing that the optimal carbon sources for butyric acid production were NAG, a major component of mucin in the human intestine, and glucose. Furthermore, the anti-inflammatory effects of butyric acid production were tested by administering these strains to DSS-induced colitis model mice. The oral administration of the E. coli Nissle 1917 strain, carrying the expression vector for BCD and BUT (EcN-BCD-BUT), was found to prevent DSS-induced damage. Introduction of the BCD expression vector into E. coli Nissle 1917 led to increased butyric acid production, which improved the strain's health-beneficial effects.


Body mass index and physical fitness among Chinese adolescents from Shandong Province: a cross-sectional study.
This study aimed to describe the most recent prevalence estimates of adolescent body mass index (BMI) and physical fitness from thirteen regions in Shandong Province, China and to examine differences by social-economic status (SES). The participants were 27,955 adolescents (mean age = 14.4 ± 1.8 years; 13,791 girls) enrolled from 91 public middle and high schools randomly selected from 13 administrative regions in Shandong Province. The Chinese National Student Physical Fitness Standard was employed to assess participants' fitness once during the school semester. Fitness assessments included BMI, a 50-m sprint run, sit-and-reach, standing-broad jump, sit-ups, pull-ups, and a 1000 m/boy or 800 m/girl distance run. Participants' fitness performance was categorized as excellent, good, pass, or no pass. The percent of Chinese adolescents categorized as "no pass" ranged from just 8.9% for BMI to 67.1% for boy pull-ups. The percent of Chinese adolescents categorized as "excellent" ranged from 5.0% for the girl sit-ups to 35.4% for the 50-m sprint run. Approximately 8.4% of the sample was categorized as excellent for BMI. SES significantly predicted both girl and boy continuous distance run scores (p < 0.05). Adolescents in lower SES strata had lower odds of achieving "pass" or better on cardio-respiratory endurance tests, muscular fitness tests, and flexibility tests, but higher odds of achieving "pass" or better on BMI compared to adolescents who were high SES (p < 0.05). The large sample of the adolescents in Shandong province, on average, had healthy weight status and achieved a high prevalence of "pass" or better on physical fitness tests. Adolescents who were low SES demonstrated poorer cardio-respiratory endurance, muscular fitness, and flexibility test achievement but better BMI achievement compared to high SES adolescents in Shandong Province, China.


Emerging Minimally Invasive Treatment Options for Male Lower Urinary Tract Symptoms.
Lower urinary tract symptoms (LUTS) are one of the most common and troublesome nonmalignant conditions affecting quality of life in aging men. A spectrum of established medical and surgical options is available to provide relief of bothersome LUTS. Both the adverse events of medication and the morbidity with surgical treatment modalities have to be counterbalanced against efficacy. Novel minimally invasive treatment options aim to be effective, ideally to be performed in an ambulatory setting under local anaesthesia and to offer a more favourable safety profile than existing reference techniques. A comprehensive, narrative review of novel minimally invasive treatment modalities for the management of male LUTS due to benign prostatic enlargement is presented. Medline, PubMed, Cochrane database, and Embase were screened for randomised controlled trials (RCTs), clinical trials, and reviews on novel minimally invasive treatment options for male LUTS due to benign prostatic enlargement. With regard to newly devised intraprostatic injectables (botulinum neurotoxin A, NX1207, PRX302), PRX302 is currently the only substance that was superior to placebo in a phase 3 RCT providing proof of efficacy and safety. The prostatic urethral lift technique has been evaluated in several phase 3 trials showing rapid and durable relief of LUTS without compromising sexual function in carefully selected patients without a prominent median lobe. The first clinical experience of the temporary implantable nitinol device demonstrated that implantation of this novel device is a safe procedure, easy, and fast to perform. Further studies are required to evaluate efficacy, durability, and to define appropriate patient selection. New ablative approaches like the image guided robotic waterjet ablation (AquaBeam) or procedures based on convective water vapour energy (Rezūm) are in the early stages of development. Prostatic artery embolization performed by interventional radiologists at specialised centres shows a high technical success rate in the treatment of bothersome LUTS. However, a substantial clinical failure rate and a particular spectrum of complications not commonly seen after urologic interventions do occur and need to be critically evaluated. Initial promising clinical results on novel minimally invasive treatment options indicate efficacy comparable to standard techniques, often associated with a more favourable safety profile, in particular with preservation of sexual function. Many of these techniques are in their infancy and based on experience of new developments in the past. Further RCTs are required to evaluate efficacy, safety, and durability of novel techniques with long-term follow-up and careful evaluation of the selection criteria, which have been applied in clinical trials. The prostatic urethral lift is the only procedure with Level 1 evidence data and that can therefore be recommended for treatment of male LUTS in clinical practice for selected patients. Minimally invasive treatment options have been developed to provide relief of lower urinary tract symptoms comparable to standard surgical techniques with a more favourable safety profile. However, long-term clinical evaluation is still needed for most of these innovations before they can be recommended to be an effective replacement for standard surgical treatment.


A Monte Carlo study of spherical electrical double layer of macroions-polyelectrolytes systems in salt free solutions.
A canonical Monte Carlo simulation is performed to investigate the microstructure and the electrical double layer (EDL) of polyelectrolytes around macroions in the bulk systems based on the primitive model. We explore the influences of particles size, chain length, and charge density of polyelectrolytes on the microscopic behavior of the macroions-polyelectrolytes systems. The simulation results show that the surface charge density and the chain length of the polyelectrolytes are two key factors that affect the microstructure of polyelectrolytes around the macroions and potential of mean force between the macroions as well as the zeta potential of the spherical EDL constructed by polyelectrolytes. The high surface charge density of a polyelectrolyte leads to the polyelectrolyte acting as a bridge for the aggregation of macroions, causing the presence of the attraction between macroions. The polyelectrolytes with a long chain length present a cooperativity effect for the adsorption of the polyelectrolytes on the surface of the macroions. Furthermore, the two key factors both induce the overcharge of the macroions. The longer the chain length and the higher surface charge density of the polyelectrolytes, the stronger is the overcharge.


Electron microscopy for ultrastructural analysis and protein localization in Saccharomyces cerevisiae.
The yeast Saccharomyces cerevisiae is a key model system for studying of a multitude of cellular processes because of its amenability to genetics, molecular biology and biochemical procedures. Ultrastructural examinations of this organism, though, are traditionally difficult because of the presence of a thick cell wall and the high density of cytoplasmic proteins. A series of recent methodological and technical developments, however, has revived interest in morphological analyses of yeast (e.g. 123). Here we present a review of established and new methods, from sample preparation to imaging, for the ultrastructural analysis of S. cerevisiae. We include information for the use of different fixation methods, embedding procedures, approaches for contrast enhancement, and sample visualization techniques, with references to successful examples. The goal of this review is to guide researchers that want to investigate a particular process at the ultrastructural level in yeast by aiding in the selection of the most appropriate approach to visualize a specific structure or subcellular compartment.


Evaluation of the temperature of different refrigerant sprays used as a pulpal test.
The temperature of different refrigerant sprays (Endo-Ice, Endo-Frost, Coolermatic and Sprayon Contact and Tuner Cleaner) used as pulpal tests were evaluated in vitro. A thermocouple placed inside the pulp chamber of a maxillary central incisor was used to register the temperature changes when the refrigerant sprays were applied with a cotton swab, for 10 s. Results indicate that Endo-Ice and Endo-Frost presented the lowest temperatures among the refrigerant sprays tested. Temperatures measured inside the pulp chamber, however, were statistically similar in all groups.


Membrane IgE and adenyl cyclase activity in the dynamics of bronchospasm. Ketotifen as a blocker of antigen action.
A continuous exposition to antigen provokes an increase of IgE synthesis in individuals sensitized to that antigen. This increase in the synthesis is hardly seen to be reflected in seric levels; however, it is clearly seen in the quantity of IgE associated with membranes as this value increases considerably. This fact is due to the characteristic of IgE which tends to fix itself to basophil membrane. On the other hand, although no difference exists in basal adenyl cyclase activity of asthmatic and healthy individuals, the sensitivity of this enzyme to isoproterenol (beta-agonist) is greater in healthy than in asthmatic individuals. The antigenic stimulus makes adenyl cyclase activity descend in these individuals; this does not happen when the cells are treated with ketotifen before stimulating them with the antigen.


Laparoscopic lymphadenectomy. Preliminary experience.
Pelvic lymphadenectomy is a well established method for staging carcinoma of the bladder and prostate. Usually it is done by open surgery, but we now report preliminary experience with the laparoscopic approach. The technique is described in detail, and the results seem to indicate that the procedure is safe, has few complications and gives less pain than open surgery, with rapid recovery and early postoperative discharge from hospital.


Liberation of carbon monoxide from formic acid mediated by molybdenum oxyanions.
Multistage mass spectrometry experiments, isotope labelling and DFT calculations were used to explore whether selective decarbonylation of formic acid could be mediated by molybdate anions [(MoO3)x(OH)]- (x = 1 and 2) via a formal catalytic cycle involving two steps. In step 1, both molybdate anions undergo gas-phase ion-molecule reactions (IMR) with formic acid to produce the coordinated formates [(MoO3)x(O2CH)]- and H2O. In step 2, both coordinated formates [(MoO3)x(O2CH)]- undergo decarbonylation under collision-induced dissociation (CID) conditions to reform the molybdate anions [(MoO3)x(OH)]- (x = 1 and 2), thus closing a formal catalytic cycle. In the case of [MoO3(O2CH)]- an additional decarboxylation channel also occurs to yield [MoO3(H)]-, which is unreactive towards formic acid. The reaction between [Mo18O3(18OH)]- and formic acid gives rise to [Mo18O3(O2CH)]- highlighting that ligand substitution occurs without 18O/16O exchange between the coordinated 18OH ligand and HC16O2H. The reaction between [(MoO3)x(OD)]- (x = 1 and 2) and DCO2H initially produces [(MoO3)x(OH)]- (x = 1 and 2), indicating that D/H exchange occurs. DFT calculations were carried out to investigate the reaction mechanisms and energetics associated with both steps of the formal catalytic cycle and to better understand the competition between decarbonylation and decarboxylation, which is crucial in developing a selective catalyst. The CO and CO2 loss channels from the monomolybdate anion [MoO3(O2CH)]- have similar barrier heights which is in agreement with experimental results where both fragmentation channels are observed. In contrast, the dimolybdate anion is more selective, since the decarbonylation pathway of [(MoO3)2(O2CH)]- is both kinetically and thermodynamically favoured, which agrees with experimental observations where the CO loss channel is solely observed.


Synchronous Left Ventricular and Endocranial Mass.
Myocardial cysts represent a miscellaneous and infrequent spectrum of conditions, with each of them coming from a different etiological background. Congenital myocardial cysts, neoplasia, cysts of infectious origin (bacterial, viral, or parasitic), and cardiac pathologies that may fake cystic content are all encompassed in this group. Although most patients are asymptomatic, some may occasionally present with obstruction, valvular dysfunction, or heart failure. Even more uncommon is the coexistence of a myocardial cyst with other extracardiac locations causing extracardiac symptoms. In this direction, the coexistence of a myocardial and endocranial cyst is extremely rare and can cause symptomatology from the affected organs (e.g., seizures). Cardiac investigation in this context is mainly dependent on non-invasive diagnostic modalities, and laboratory procedures. In this case report, we present a 26-year-old Congolese male admitted with dyspnea and epileptic seizures. Echocardiography revealed left ventricular and both mitral and tricuspid valve dysfunction and the presence of two myocardial cysts, while brain computed tomography showed an additional frontal cystic lesion. A precise diagnostic workup with a combination of non-invasive imaging, laboratory results, and epidemiology data assisted the diagnosis and guided the most suitable therapeutic choice.


Use of anticholinergic therapy in men.
Lower urinary tract symptoms in men usually include symptoms of bladder overactivity such as urinary frequency, urgency or nocturia. These are often the initial presenting symptoms for men seeking medical attention for urinary dysfunction. The prevalence of overactive bladder in men is similar to women and increases with advancing age. While women with these symptoms are treated primarily with anticholinergic therapy, there is reluctance to use these agents in men due to concerns regarding worsening obstructive symptoms or urinary retention exacerbated by a large prostate. For men, alpha blocker monotherapy remains the primary therapy for lower urinary tract symptoms despite the fact that a larger fraction of men continue to experience symptoms of overactive bladder. There is emerging body of evidence that the use of anticholinergic agents may be safe and effective in men. We will discuss the rationale for the use of anticholinergic therapy in men with bladder overactivity, either alone, or in combination with alpha blockers. We will review the current literature on the topic and discuss potential future directions in the management of overactive bladder in men.


Topographical Distribution of Epileptogenic Tubers in Patients With Tuberous Sclerosis Complex.
Tuberous sclerosis complex is a multisystem genetic syndrome often affecting the central nervous system. The purpose of the current study was to identify topographical patterns in the distribution specific to epileptogenic (n = 37) and nonepileptogenic (n = 544) tubers throughout the brain for a cohort of 23 tuberous sclerosis complex patients with a history of seizures. Tubers localized to the inferior parietal lobes, middle frontal lobes, middle temporal lobes, or central sulcus regions were associated with a high frequency of epileptogenic tubers. Epileptogenic tubers occurred statistically more frequently within the inferior parietal lobe and within the central sulcus region in children younger than 1 or between 1 and 3 years old, respectively. Results imply seizure activity in tuberous sclerosis complex patients can be associated with the location of cortical tubers.


Social work post-disaster response in Iran: A case study of the 2019 mass flooding in Poldokhtar, Lorestan.
Flash-flooding affected Iran in March 2019 causing the displacement of thousands of people. Social workers established a Child Friendly Space (CFS) and applied comprehensive case management to provide psychosocial support for people who were affected by flooding (PWAF) (n = 565) in a community in Poldokhtar, covering a period of 3 months. Outreach services, involving community-volunteers, providing counseling, establishing CFS, training PWAF for reducing violence, and preventing child abuse were essential social work post-disaster interventions to support vulnerable populations. The article reflects upon the often-neglected role of social workers in post-disaster settings, and brings new material for discussion from the unexplored field of Iranian social workers.


Closed head injuries: where does delay occur in the process of transfer to neurosurgical care?
In the United Kingdom most head injury patients are first admitted to a District General Hospital (DGH); selected patients are later referred to a Neurosurgical Unit (NSU). It is known that this system leads to some avoidable deaths. In an attempt to discover whether the minimum amount of time involved in such a system of secondary referral must of necessity put some patients at risk, and whether any significant delay could be eliminated without radical change in this system, we have carried out a detailed prospective analysis of the sequence of events involved in the emergency transfer of 117 consecutive patients with suspected traumatic intracranial haematoma (TICH). We discovered that once it had been decided to transfer a patient, the actual process of transfer consumed relatively little time regardless of the distance from the DGH to the NSU. Where harmful avoidable delay did occur was at the DGH itself either from failure to institute appropriate treatment for non-cranial injuries or from failure to realise that transfer was necessary. We believe that the geographical dispersal of neurosurgical services would not improve the outlook of patients with head injury. The optimum outcome could be achieved by concentrating head injury admissions at selected DGH's each of which would be equipped both with a CT scanner linked to a neurosurgical unit and a standby ambulance for transferring head injury patients.(ABSTRACT TRUNCATED AT 250 WORDS)


Introducing key microbes from high productive soil transforms native soil microbial community of low productive soil.
This study aimed to understand the changes in rhizosphere microbial structure and diversity of an average corn yielding field site soil with the introduced microbial candidates from a high-yielding site. Soils used in this study were from two growers' fields located in Dunnville, Ontario, Canada, where one of the farms has an exceptional high corn yield (G-site soil; ca 20 tons/acre) and the other yields an average crop (H-site soil; 12 tons/acre) (8 years of unpublished A & L data). In growth room experiments using wheat as the indicator crop, calcium alginate beads with microbes composed of Azospirillum lipoferum, Rhizobium leguminosarum, Burkholderia ambifaria, Burkholderia graminis, Burkholderia vietnamiensis, Pseudomonas lurida, Exiguobacterium acetylicum, Kosakonia cowanii, and Paenibacillus polymyxa was introduced into the soil at planting to the average-yielding soil. These bacteria had been isolated from the high-yielding farm soil. Among the nine microbial candidates tested, three (P. polymyxa, E. acetylicum and K. cowanii) significantly impacted the plant health and biometrics in addition to microbial richness and diversity, where the microbial profile became very similar to the high productive G-site soil. One hundred and forty-two bacterial terminal restriction fragments (TRFs) were involved in the community shift and 48 of them showed significant correlation to several interacting soil factors. This study indicates the potential of shifting microbial profiles of average-yielding soils by introducing key candidates from highly productive soils to increase biological soil health.


Rectal Instillation of Cold Fluids for Targeted Temperature Management After Cardiac Arrest: A Case Report.
The optimal method of temperature management after cardiac arrest remains unknown. Methods that are most effective are usually invasive and expensive. Noninvasive methods are not as effective and obstruct access to the patient. Temperature management via rectal cooling offers some potential advantages in survivors of cardiac arrest, namely, relatively large volumes of temperature-controlled fluids can be instilled, access to the patient is not obstructed, and fluid overload can be ameliorated by removal of a fraction of instilled fluid. We used rectal cooling in a 72-year-old male comatose survivor of cardiac arrest with an initial body temperature of 36.8°C. We instilled 3000 mL of normal saline at 4°C in 75 minutes, and ∼2000 mL of effluent fluid was removed via gravity at 105 minutes after instillation. At 135 minutes, temperature decreased to a minimum of 35.2°C. No leakage was observed. Standard procedures (insertion of central venous and arterial catheters, electrocardiography, echocardiography, chest radiography) were performed with a rectal catheter in situ. At 210 minutes after instillation, the catheter was removed and there were no clinical signs of rectal injury after removal. To conclude, rectal instillation of cold fluids resulted in a significant decrease of body temperature and we observed no major side effects. Fluid overloading was avoided by removing effluent fluid. Additional studies are needed if this technique is to gain more widespread use.


Deep learning and differential equations for modeling changes in individual-level latent dynamics between observation periods.
When modeling longitudinal biomedical data, often dimensionality reduction as well as dynamic modeling in the resulting latent representation is needed. This can be achieved by artificial neural networks for dimension reduction and differential equations for dynamic modeling of individual-level trajectories. However, such approaches so far assume that parameters of individual-level dynamics are constant throughout the observation period. Motivated by an application from psychological resilience research, we propose an extension where different sets of differential equation parameters are allowed for observation subperiods. Still, estimation for intra-individual subperiods is coupled for being able to fit the model also with a relatively small dataset. We subsequently derive prediction targets from individual dynamic models of resilience in the application. These serve as outcomes for predicting resilience from characteristics of individuals, measured at baseline and a follow-up time point, and selecting a small set of important predictors. Our approach is seen to successfully identify individual-level parameters of dynamic models that allow to stably select predictors, that is, resilience factors. Furthermore, we can identify those characteristics of individuals that are the most promising for updates at follow-up, which might inform future study design. This underlines the usefulness of our proposed deep dynamic modeling approach with changes in parameters between observation subperiods.


Myocardial abscess due to Klebsiella pneumoniae complicating acute infarction.
A case is described in which Klebsiella pneumoniae urosepsis associated with acute myocardial infarction resulted in myocardial abscess and papillary muscle rupture. The diagnosis was made during surgery for mitral valve replacement. The patient improved after therapy with cefotaxime; however, cardiac rupture occurred on the sixth postoperative day. The pathogenesis of myocardial abscess and the use of non-invasive techniques for diagnosis are discussed.


Targeted mutagenesis using zinc-finger nucleases in perennial fruit trees.
Targeting a gene in apple or fig with ZFN, introduced by transient or stable transformation, should allow genome editing with high precision to advance basic science and breeding programs. Genome editing is a powerful tool for precise gene manipulation in any organism; it has recently been shown to be of great value for annual plants. Classical breeding strategies using conventional cross-breeding and induced mutations have played an important role in the development of new cultivars in fruit trees. However, fruit-tree breeding is a lengthy process with many limitations. Efficient and widely applied methods for targeted modification of fruit-tree genomes are not yet available. In this study, transgenic apple and fig lines carrying a zinc-finger nuclease (ZFNs) under the control of a heat-shock promoter were developed. Editing of a mutated uidA gene, following expression of the ZFN genes by heat shock, was confirmed by GUS staining and PCR product sequencing. Finally, whole plants with a repaired uidA gene due to deletion of a stop codon were regenerated. The ZFN-mediated gene modifications were stable and passed onto regenerants from ZFN-treated tissue cultures. This is the first demonstration of efficient and precise genome editing, using ZFN at a specific genomic locus, in two different perennial fruit trees-apple and fig. We conclude that targeting a gene in apple or fig with a ZFN introduced by transient or stable transformation should allow knockout of a gene of interest. Using this technology for genome editing allows for marker gene-independent and antibiotic selection-free genome engineering with high precision in fruit trees to advance basic science as well as nontransgenic breeding programs.


Macrophages activate mesenchymal stem cells to acquire cancer-associated fibroblast-like features resulting in gastric epithelial cell lesions and malignant transformation in vitro.
The majority of premalignant gastric lesions develop in the mucosa that has been modified by chronic inflammation. As components of the gastritis microenvironment, mesenchymal stem cells (MSCs) and macrophages are critically involved in the initiation and development of the chronic gastritis-associated gastric epithelial lesions/malignancy process. However, in this process, the underlying mechanism of macrophages interacting with MSCs, particularly the effect of macrophages on MSCs phenotype and function remains to be elucidated. The present study revealed that human umbilical cord-derived MSCs were induced to differentiate into cancer-associated fibroblasts (CAFs) phenotype by co-culture with macrophages (THP-1 cells) in vitro, and which resulted in gastric epithelial lesions/potential malignancy via epithelial-mesenchymal transition-like changes. The results of the present study indicated that macrophages could induce MSCs to acquire CAF-like features and a pro-inflammatory phenotype to remodel the inflammatory microenvironment, which could potentiate oncogenic transformation of gastric epithelium cells. The present study provides potential targets and options for inflammation-associated gastric cancer prevention and intervention.


Does hyperparathyroidism cause hypergastrinemia?
To define the relationship between hyperparathyroidism (HPT) and gastric function, 31 patients with HPT were prospectively studied before and 2 to 25 months after parathyroidectomy. The gastrin response to a standard test meal (STM), the basal acid output (BAO), and the peak acid output (PAO) were determined. Parathormone and calcium were elevated in all patients and returned to normal following parathyroidectomy. The mean fasting gastrin concentration, mean integrated gastrin response (IGR) to feeding, mean basal acid output (BAO), and mean peak acid output (PAO) were not changed by successful parathyroidectomy. There was no significant correlation between gastrin concentration or gastrin response to feeding and gastric acid secretion. Eight of 31 HPT patients had fasting gastrin concentrations above normal preoperatively and remained so postoperatively. Hypergastrinemia in six of these eight patients could be explained by the Zollinger-Ellison (Z-E) syndrome or chronic atrophic gastritis. The hypothesis that peptic ulcer disease seen in some HPT patients is the result of calcium-induced hypergastrinemia causing gastric hypersecretion is not supported by this study.


Physiological response of Tetrahymena pyriformis during adaptation to elevated external salinity.
Tetrahymena pyriformis exhibited a complex physiological and biochemical response during sudden exposure to high (200 mM) NaCl concentrations. The growth rate was reduced significantly. Uptake of precursor molecules and synthesis of macromolecules was reduced to 30% of control. Sudden exposure of Tetrahymena pyriformis to 200 mM NaCl resulted in increased proteolysis of already existing proteins and affected the electrophoretic pattern of the total proteins.


Energy partitioning for "fuzzy" atoms.
The total energy of a molecule is presented as a sum of one- and two-atomic energy components in terms of "fuzzy" atoms, i.e., such divisions of the three-dimensional physical space into atomic regions in which the regions assigned to the individual atoms have no sharp boundaries but exhibit a continuous transition from one to another. By proper definitions the energy components are on the chemical energy scale. The method is realized by using Becke's integration scheme and weight function permitting very effective numerical integrations.


Reevaluation of the taxonomic status of Halipegus occidualis Stafford, 1905 (Digenea: Hemiuridae).
In response to confusion regarding the taxonomy of halipegines inhabiting North American amphibians, the reproductive structures of the hemiurid Halipegus occidualis are described from adult worms reared from cercariae shed by Helisoma anceps from Charlie's Pond, North Carolina. The report of a Laurer's canal is confirmed and the presence of a canalicular seminal receptacle established. The suggestion that H. eccentricus Thomas, 1939 be considered a junior synonym of H. occidualis Stafford, 1905 is rejected.


Assessment of microbial growth in intravenous immune globulin preparations.
The ability of intravenous immune globulin (IVIG) products to support bacterial and yeast growth was studied. Microtiter plates containing preparations of eight commercially available IVIG products were inoculated with 10(5) colony-forming units (CFUs) of bacteria per milliliter or 10(3) CFUs of yeast cells per milliliter. The organisms used were Candida albicans, Torulopsis glabrata, Pseudomonas aeruginosa, Staphylococcus epidermidis, and Klebsiella pneumoniae. The plates were incubated at 3, 25, or 37 degrees C for seven days. For each organism and each temperature, a total of 16 identical wells were studied per preparation. Optical density was measured at 24-hour intervals to determine bacterial growth; yeast growth was determined visually. None of the IVIG preparations supported bacterial growth at any temperature over the seven-day period. No preparation supported visible yeast growth at 3 degrees C; however, most of the preparations did support yeast growth at 25 and 37 degrees C. The failure of the IVIG preparations to support bacterial growth at all temperatures and yeast growth at 3 degrees C suggests that a reconsideration of recommended expiration dates for IVIG products may be warranted.


[Examination of cerebral electrical admittance plethysmogram in healthy newborns].
Cerebral electrical admittance plethysmography is a novel noninvasive technique for evaluating cerebral hemodynamics. This study aimed to measure the reference values of cerebral electrical admittance plethysmogram in healthy newborns. Bilateral cerebral electrical admittance plethysmography was performed in 40 healthy newborns. The values of various indexes of cerebral electrical admittance plethysmogram in 40 newborns were obtained by this technique. The index of Admittance Differential Loop (ADL) I+II at the third and fourth days after birth was significantly higher than that at the first day of life (P < 0.05). There were significant differences in the index of ADL I+II and the ratio of Hs to b-S (Hs/ b-S) among different birth weight groups (P < 0.05). No significant differences were found in all the indexes of cerebral electrical admittance plethysmogram between the left and right brain of newborns. Gender and parturition mode had also no effects on these indexes. The research reported the reference values of cerebral electrical admittance plethysmogram in healthy newborns. The postnatal age and birth weight are influencing factors for the cerebral electrical admittance plethysmogram.


Assessment of genetic effects and pesticide exposure of farmers in NW Greece.
The present study aims at evaluating potential genotoxic and cytotoxic effects caused by the occupational exposure of farmers to pesticide mixtures in the Aitoloakarnania Prefecture (Greece). The aforementioned assessment was conducted through in vivo Cytokinesis Block Micronucleus assay (CBMN assay) in peripheral blood lymphocytes, in relation to chemical analysis of pesticide residues in blood samples. The exposure of the farmers' population studied to different combinations of pesticides induced significant differences in the frequencies of micronuclei (MN) compared to those of the control group. Furthermore, our results indicated a possible clastogenic and aneugenic effect of pesticides on the genetic material of the farmers exposed. Five pesticides (trifluralin, chlorpyriphos methyl, metolachlor, fenthion and dimethoate) and three metabolites (fenthion sulfone, fenthion sulfoxide and 4,4' DDE) were detected in the 62.5% of blood samples, with mean concentrations ranging from 0.4 ng/ml to 48 ng/ml. Since the farmers studied probably exhibit detectable levels of systematic exposure to the pesticides applied, continuous educational programs focused on the rational and safe use of pesticides, together with implementation of risk communication strategies among farmers are highly recommended.


Determination of Schirmer tear test-1 values in clinically normal alpacas (Vicugña pacos) in North America.
To determine the normal reference range for Schirmer tear test-1 (STT-1) values in eyes of healthy alpacas (Vicugña pacos). Complete ophthalmic examinations were performed on forty healthy alpacas (80 eyes). STT-1 values were obtained in both eyes of all alpacas using a commercial STT strip of a single lot number. Data were analyzed, using a doubly repeated measures ANOVA design, Student's paired t-test, and Pearson correlation test, with P ≤ 0.05 considered significant. The STT-1 values ± standard deviation (SD) were 20.80 ± 4.01 mm/min OD, 20.00 ± 4.13 mm/min OS, and 20.88 ± 4.04 mm/min OU (range 15.50-30.50 mm/min). No significant differences in STT-1 were found between OD and OS. STT-1 was not significantly affected by breed. Schirmer tear test-1 values were significantly increased by 3.45 mm/min for every 10 year increase in age. This study provides a reference range of STT-1 in the healthy alpaca which can assist veterinarians in diagnosing potential keratoconjunctivitis sicca, tear film abnormalities, as well as ocular surface diseases in alpacas.


Pleural effusion after plasmapheresis in Waldenström's macroglobulinemia.
Transudative pleural effusion developed after plasmapheresis in a patient with Waldenström's macroglobulinemia and hyperviscosity. When albumin was added to the apheresis, the effusion resolved. We therefore suspect that rapid removal of high-molecular-weight IgM led to an abrupt decrease in intravascular colloid oncotic pressure and transudation of fluid into the pleural space. Plasmapheresis can cause pleural effusions in patients who were previously hemodynamically compensated at high levels of colloid oncotic pressure.


Pleomorphic malignant histiocytoma of pulmonary arteries presenting as pulmonary aneurysms.
Pulmonary aneurysms and primary neoplasms of the great vessels are very rare entities; pulmonary aneurysms are commonly associated with congenital heart diseases, and less frequently in atherosclerosis, medial cystic necrosis, trauma, infection, and inflammatory processes. Many patients have pulmonary hypertension, most frequently resulting from pulmonary artery sarcomas mimicking pulmonary thromboembolism. Symptoms are vague. In 30% of cases, rupture and death occur, related to pulmonary aneurysms. We present the case of a patient with a diagnosis of pulmonary artery pleomorphic malignant histiocytoma that presented as a right pulmonary aneurysm thrombosis and a contained rupture of a left pulmonary aneurysm.


Serum luteinizing hormone pulsatility and intratesticular testosterone and oestradiol concentrations in idiopathic infertile men with high and normal follicle stimulating hormone serum concentrations.
The purpose of the study was to evaluate pulsatile luteinizing hormone (LH) release and intratesticular concentrations of testosterone and oestradiol in infertile men, to determine if alterations in gonadotrophin secretion are associated with changes in the testicular concentrations of steroids. Patients with idiopathic oligo/azoospermia were divided into a high follicle stimulating hormone (FSH) group (n = 5) and a normal FSH group (n = 6). Blood samples were taken every 15 min for 6 h to determine LH, FSH, testosterone, oestradiol, sex hormone binding globulin, bioactive LH and bioavailable testosterone. The patients underwent a bilateral testicular biopsy for histological assessment and to determine testosterone and oestradiol concentrations. Serum measurements were compared with those of seven fertile men. The high FSH group had a higher concentration of serum LH and oestradiol than normal men (P < 0.01) and showed a lower frequency of LH pulses than the normal FSH group and control men (P < 0.01). Intratesticular oestradiol was higher in the high FSH group (P < 0.001), with a lower testosterone/oestradiol ratio (P < 0.01). Patients showed a negative correlation between the serum testosterone/LH ratio and FSH (r = -0.75; P < 0.01) and a positive correlation between the testicular oestradiol concentration and serum FSH (r = 0.86; P < 0.01). The histopathological examination only showed a smaller tube diameter in the high FSH group (P < 0.05). These data seem to indicate that a higher intratesticular concentration of oestradiol with a lower testosterone/oestradiol ratio in the high FSH group could have a deleterious effect on spermatogenesis.


Comparative bioavailability of two oral formulations of flurazepam in human subjects.
The systemic availability of an investigational oral formulation of flurazepam was compared to that of a commercially available product whose therapeutic efficacy has been well established by usage. The experiment was designed to dissociate formula on factors from all other sources of variation including differences between subjects, sexes, sequences of administration, experimental periods, as well as sex by sequence, sex by period, and sex by formulation interactions. Systemic availability was assessed by conventional pharmacokinetic techniques. Pharmacokinetic interpretation and statistical analysis of plasma concentrations of flurazepam and its major blood metabolites namely N-1-hydroxyethylfurazepam and N-1-desalkylflurazepam as a function of time and of systemic availability indicators revealed a nearly identical biopharmaceutical behaviour for the two preparations. A significant difference could be seen in the plasma levels of N-1-desalkylflurazepam between male and female subjects. The results collectively indicate a very similar biopharmaceutical performance of the two oral formulations of flurazepam.


Antigenic link between human interferons-alpha and -beta: the common epitope 1.
An until now unobserved consistent antigenic structure, tentatively named "common epitope 1," was detected on molecules of human recombinant (rHu) IFN-alpha 2 and natural HuIFN-beta by testing with monoclonal and polyclonal antibodies. The monoclonal antibody B6, obtained after immunization of BALB/c mice with human fibroblast IFN-beta, was capable of binding and neutralizing both IFN-alpha 2 and natural IFN-beta. The neutralizing activity of monoclonal antibody B6 was completely inhibited by a synthetic hexapeptide which corresponded to the amino acid sequence of IFN-alpha 2 in positions 132-137. Although a corresponding sequence of amino acids in the IFN-beta molecule was localized to the region 134-139 and shows only a 66% homology with the assumed IFN-alpha 2 binding site, lysine at position 132 in IFN-alpha 2 and at position 134 in IFN-beta seems to be crucial for establishment of the common epitope. Its existence was supported by experiments using polyclonal antibodies. Antiserum to IFN-alpha 2 showed cross-neutralization with IFN-beta, and vice versa, antiserum to IFN-beta cross-reacted with IFN-alpha 2. The ability for cross-neutralization by both polyclonal antisera was abolished in the presence of IFN-alpha 2 hexapeptide SH 132-137. No cross-reacting epitope could be detected on the IFN-alpha 1 molecule. These findings are the first evidence of a homology between human IFNs of alpha and beta types at the antigenic level. They indicate that the antigenic distinction between IFNs of alpha and beta types is not absolute.


Principles of CT and CT technology.
This article provides a review of the basic principles of CT within the context of the evolution of CT. Modern CT technology can be understood as a natural progression of improvements and innovations in response to both engineering problems and clinical requirements. Detailed discussions of multislice CT, CT image quality evaluation, and radiation doses in CT will be presented in upcoming articles in this series.


Positive end-expiratory pressure lowers the risk of laser-induced polyvinylchloride tracheal-tube fires.
The possibility of ignition of polyvinylchloride (PVC) tracheal tubes by a CO2 laser is of concern in patients undergoing CO2 laser surgery of the airway. The authors analyzed the ignition of PVC tracheal tubes by a CO2 laser beam to determine what variables were involved, and then designed a study to determine how they affect the incidence of such fires. For the analysis, PVC tracheal tubes were enclosed in a clear plexiglass enclosure and a laser beam was focused on the tubes. The enclosure contained one of three different gas combinations. A high-speed camera photographed the tubes during the analysis and showed that tracheal tube perforation always preceded ignition in all three gas combinations. These results led to the hypothesis that intraluminal gauge pressure (IGP) may be an important variable, because it would affect the flow of O2 across the perforation. This hypothesis was tested by aiming a CO2 laser beam at PVC tracheal tubes and varying IGP in 0.25-cm H2O increments, from 0.25 to 28 cm H2O, while nitrogen or helium containing O2 at 40, 50, or 60% flowed through the tubes. To simulate the clinical effect of IGP on PVC tracheal tube ignition, we used a mechanical lung model connected to an anesthesia breathing circuit with a standing bellows ventilator in which 60% He and 40% O2 flowed through a PVC tracheal tube. Laser beam exposure was started at three different times during the respiratory cycle: at the start of inspiration, at the end of inspiration, or at the end of expiration. Also, for each condition, trials were made at baseline circuit pressure (2.5 cm H2O) and at 5.0 cm H2O by the addition of 2.5 cm H2O positive end-expiratory pressure (PEEP) applied to the circuit. The incidence of tracheal tube ignition decreased as IGP increased. The IGP at which ignition did not occur (which increased as O2 concentration increased) did not differ between N2 and He at 40% O2, but was twice as high with N2 as with He at O2 of 50% and 60%. Fires never occurred when PEEP was added to the system and, when PEEP was not added, always started during the last 2 s of end expiration (when airway pressure is lowest), regardless of when the laser beam was activated. It is recommended that, in addition to other safety practices, PEEP be added to the breathing circuit during CO2 laser operations on the airway in which PVC tracheal tubes or laser-resistant tracheal tubes with PVC components are used.


A Systematic Review of Patient Education Strategies for Oncology Patients in Low- and Middle-Income Countries.
Patient education can facilitate early cancer diagnosis, enhance treatment adherence, and improve outcomes. While there is increasing cancer burden in low- and middle-income countries (LMICs), there is little research to inform successful patient education in these regions. This systematic review summarizes the existing literature on oncology education and evaluation strategies in LMICs, identifies best practices, and highlights areas which require further investigation. The review was conducted using PRISMA guidelines and an a priori protocol. Four databases (Ovid Medline, Cochrane Libraries, Embase, and Cabi) were searched in December 2021. Two independent reviewers evaluated studies for inclusion. Using a coded data extraction form, information was collected about the study site, intervention characteristics, and evaluation methods. Of the 2047 articles generated in the search, 77 met the inclusion criteria. Twenty-four countries were represented; only 6 studies (8%) were in low-income countries. The most common education methods included technology-based interventions (31, 40%) and visual pamphlets or posters (20, 26%). More than one education method was used in 57 (74%) studies. Nurses were the most frequent educators (25, 33%). An evaluation was included in 74 (96%) studies, though only 41 (55%) studies used a validated tool. Patient knowledge was the most common measured outcome in 35 (47%) studies. There is limited empiric research on oncology patient education in LMICs. The available data show heterogeneity in education approaches and gaps in evaluation. Further research to determine successful patient education and evaluation strategies is urgently needed to improve treatment cancer outcomes in LMICs.


Inulin crystal initiation via a glucose-fructose cross-link of adjacent polymer chains: atomic force microscopy and static molecular modelling.
Semi-crystalline microparticles of inulin (MPI) have clinical utility as potent human vaccine adjuvants but their relevant surface structure and crystal assembly remain undefined. We show inulin crystal surfaces to resemble multi-layered, discoid radial spherulites resulting from very rapid formation of complex tertiary structures, implying directed crystal initiation. Physical and in silico molecular modelling of unit cells confirm steric feasibility of initiation by hydrogen-bonded cross-linking of terminal glucose to a fructose of another chain, mimicking bonding in sucrose crystals. A strong, chelate-like dual H-bond is proposed to compel the known antiparallel alignment of inulin chains. Such cross-linking would require one extra fructose per chain in the native inulin crystal, as observed. Completion of five H-bonded internal ring-domains would 'lock in' each new 6-fructose structural unit of each antiparallel helix pair to create a new isoform. All known properties of inulin isoforms follow readily from these concepts.


Immunochemical properties of Vi antigen from Salmonella typhi Ty2: presence of two antigenic determinants.
Antigen Vi of Salmonella typhi was found to have at least two antigenic determinants. In one of them, O-acetyl moiety played a dominant role. The second antigenic determinant did not involve O-acetyl residues, but both carboxyl and N-acetyl groups were necessary for the antigen-antibody reaction. These results were obtained by performing serological tests with antigen Vi, with its structural analog, polygalacturonic acid, and with the derivatives of both polysaccharides.


Novel fast-track recovery protocol for alternative access transcatheter aortic valve replacement: application to non-femoral approaches.
Although the transfemoral approach for transcatheter aortic valve replacement is the preferred choice, alternative access remains indicated for inadequate iliofemoral vessels. We report the successful implementation of a novel fast-track (FT) protocol for patients undergoing alternative access transcatheter aortic valve replacement compared with conventional controls. Between September 2014 and January 2017, 31 and 23 patients underwent alternative access transcatheter aortic valve replacement under FT and pre-fast-track (p-FT) protocols, respectively. Comparisons of outcomes (in terms of mortality, complications, readmissions and resource utilization) were made before and after the implantation of the FT protocol in September 2015. Overall, mean age was 78.7 years in FT and 79.6 years in p-FT patients (P = 0.71). There were no significant differences in procedural (3.2% vs 13.0%, P = 0.301) or 90-day mortality (3.2% vs 17.4%, P = 0.151) between the FT and p-FT groups, respectively. Compared with p-FT patients, FT patients had significantly shorter intensive care unit stays (12 h vs 27 h, P = 0.006) and a trend towards more discharges within 3 days (41.9% vs 17.4%, P = 0.081). Resource utilization analyses projected a 56% and 17% reduction in the mean intensive care unit time (hours) per 100 patients and the total length of stay (days) per 100 patients, respectively, with respect to the FT approach. This pilot study demonstrates the feasibility and safety of the novel FT protocol for alternative access transcatheter aortic valve replacement, resulting in shorter intensive care unit stays, without increasing procedural complications or readmissions. With the expected increase in transcatheter aortic valve replacement utilization, FT protocols should be integrated with a multidisciplinary heart team approach to enhance patient recovery and optimize resource utilization.


Semitubular blade plate for fixation in the proximal humerus.
Rigid internal fixation is frequently difficult to obtain in the proximal humerus, as osteoporotic bone and small fracture fragments may preclude firm purchase of plates and/or screws. We describe our clinical results using a semitubular plate, fashioned into a blade plate device, for fixation of four displaced fractures and three osteotomies of the proximal humerus. All patients were clinically and radiographically united by 4 months postoperatively and had a functional range of motion. The strength of this fixation was compared to that of an AO "T" plate in an oblique subcapital osteotomy model using 10 matched pairs of human humeri. No statistically significant difference could be demonstrated between the two fixation methods with regard to load to failure, yield load, energy absorbed to failure, or stiffness. As a consequence of these studies, we believe the semitubular blade plate expands the options available for challenging fixations in the proximal humerus.


Demographics and Injuries Associated With Knee Dislocation: A Prospective Review of 303 Patients.
Information on the incidence, injury mechanisms, ligament injury patterns, and associated injuries of knee dislocations is lacking in the literature. There is a need to characterize ligament injury patterns and associated injuries in knee dislocations to avoid missing common associated diagnoses and to plan surgical treatment. To evaluate patient demographics, ligament injury patterns and associated injury patterns, and associated injuries in patients with knee dislocation. Cross-sectional study; Level of evidence, 3. A total of 303 patients with knee dislocations treated at a single level 1 trauma center were followed prospectively. Injury mechanism; ligament injury patterns; associated neurovascular, meniscal, and cartilage injuries; and surgical complications were recorded. The Schenck knee dislocation classification was used to classify the ligament injury patterns. The mean age at injury was 37.8 ± 15.3 years. Of the 303 patients included, 65% were male and 35% were female. There was an equal distribution of high-energy and low-energy injuries. Injury to 3 major ligaments was the most common, with Schenck classification type KD III-M constituting 52.4% of the injuries and KD III-L comprising 28.1%. Meniscal injuries and cartilage injuries occurred in 37.3% and 28.3% of patients, respectively. Patients with acute injuries had significantly lower odds of a cartilage injury than those with chronic injuries (odds ratio [OR], 0.28; 95% CI, 0.15-0.50; P < .001). Peroneal nerve injuries were recorded in 19.2% of patients (10.9% partial and 8.3% complete deficit), while vascular injuries were recorded in 5%. The odds of having a common peroneal nerve injury were 42 times greater (P < .001) among those with posterolateral corner injury (KD III-L) than those without. The odds for popliteal artery injury were 9 times greater (P = .001) among those with KD III-L injuries than other ligament injury types. Medial-sided bicruciate injuries were the most common injury pattern in knee dislocations. Cartilage injuries were common in chronically treated patients. There was a significant risk of peroneal nerve injury with lateral-sided injuries.


Brain asymmetry in the white matter making and globularity.
Recent studies from the field of language genetics and evolutionary anthropology have put forward the hypothesis that the emergence of our species-specific brain is to be understood not in terms of size, but in light of developmental changes that gave rise to a more globular braincase configuration after the split from Neanderthals-Denisovans. On the grounds that (i) white matter myelination is delayed relative to other brain structures and, in humans, is protracted compared with other primates and that (ii) neural connectivity is linked genetically to our brain/skull morphology and language-ready brain, I argue that one significant evolutionary change in Homo sapiens' lineage is the interhemispheric connectivity mediated by the Corpus Callosum. The size, myelination and fiber caliber of the Corpus Callosum present an anterior-to-posterior increase, in a way that inter-hemispheric connectivity is more prominent in the sensory motor areas, whereas "high- order" areas are more intra-hemispherically connected. Building on evidence from language-processing studies that account for this asymmetry ('lateralization') in terms of brain rhythms, I present an evo-devo hypothesis according to which the myelination of the Corpus Callosum, Brain Asymmetry, and Globularity are conjectured to make up the angles of a co-evolutionary triangle that gave rise to our language-ready brain.


Fabrication of uniform graphene discs via transversal cutting of carbon nanofibers.
The graphene discs with well-defined shape are successfully fabricated using a simple oxidation and exfoliation process of high-crystalline carbon nanofibers (CNFs). To control the shapes of graphene discs, two different types of CNFs (platelet and herringbone-type) are used as starting materials. The CNFs are formed by the perpendicular stacking of graphene discs, resulting in free edges on the external surface and ready access to interlay spaces. Interestingly, the diameter and shape of the graphene discs can be controlled by selectively designing the morphology of starting materials and optimizing the cutting method. In addition, a mechanical reduction method for oxidized graphene discs is also proposed in order to combine the high recovery of π-conjugated electronic structure with the solution processability of graphene discs. The reduced graphene discs can be formed without any additives, such as reducing agent, and are highly dispersed in different solvents with a high content of graphene discs. This novel strategy offers great possibility for fabricating various graphene-based nanomaterials with rational nanostructure design.


DNA methylations of brain-derived neurotrophic factor exon VI are associated with major depressive disorder and antidepressant-induced remission in females.
Brain-derived neurotrophic factor (BDNF) has been suggested to play important roles in major depressive disorder (MDD) and antidepressant treatment. The main purpose of this study was to evaluate the association of DNA methylation changes in the BDNF gene with MDD and antidepressant treatment. A total of 291 MDD patients and 100 healthy controls were included and followed up for 6 weeks. The Hamilton Depression Rating Scale-17 (HDRS-17) was used to measure treatment improvement. The life events scales (LES) and childhood trauma questionnaire (CTQ) were used to rate recent and early life stress. DNA methylation levels of CpG sites in the BDNF gene were measured. Two CpG sites in BDNF exon VI (BDNF133 and BDNF134) were demonstrated to have significantly higher methylation in MDD patients than in controls (both FDR-adjusted P = 0.001). A logistics regression model indicated that the interaction between the hypermethylation of BDNF133 and negative subscore of LES was associated to MDD (OR=0.0075, P<0.001). Methylation of BDNF140 at baseline was significantly elevated in remitters (FDR-adjusted P = 0.046) at week 6. In subgroup analyses, these findings could be replicated in females, but not in males. The methylation status of BDNF after 6 weeks of antidepressant treatment was not measured and the DNA methylation were detected in peripheral blood cells. These findings highlight gender-specific alteration of methylation at several CpG sites in BDNF exon VI as a promising candidate indicator of MDD and antidepressant-induced remission.


[Staining of semithin Durcupan sections].
The author described a modification of a simple undemanding method of staining Durcupan section of tissues fixed in aldehydes and in osmium. Methylene blue with azure II was used for the staining. After rinsing in water the sections were counterstained with basic fuchsin, or with saphranin O. Basophil structures are stained blue or even violet, fat and erythrocytes blue-green. After counterstaining with saphranin, mucus, collagen, and glycogen come out pink, or red case fuschin is used. Elastic tissue come out violet. The colours are bright, full of contrast, and practically fast.